Provider Demographics
NPI:1710046081
Name:GEETE, JAYANT RAGHUNATH (MD)
Entity type:Individual
Prefix:DR
First Name:JAYANT
Middle Name:RAGHUNATH
Last Name:GEETE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8727 E MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5060
Mailing Address - Country:US
Mailing Address - Phone:602-635-6319
Mailing Address - Fax:
Practice Address - Street 1:650 E INDIAN SCHOOL RD
Practice Address - Street 2:116-A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1839
Practice Address - Country:US
Practice Address - Phone:602-222-2752
Practice Address - Fax:602-222-2723
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ324662084P0800X
KY356962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64023997Medicaid
KY1250415Medicare ID - Type Unspecified
KYH26460Medicare UPIN
KY64023997Medicaid